PREVALENCE OF UNDER NUTRITION AND ASSOCIATED FACTORS AMONG

ADOLESCENT GIRLS IN SELECTED SCHOOL IN KOLFE KERANIYO SUB CITY ADDIS

ABABA, ETHIOPIA.

BY: SIMRET GIDEY (BSC.)

ADVISOR: ESKINDER WOLKA (PHD)

PROPOSAL SUBMITTED TO THE SCHOOL OF GRADUATE STUDENT OF UNITY

UNIVERSITY IN PARTIAL FULFILLMENT OF THE REQUAREMENTS FOR THE
DEGREE OF MASTERS OF PUBLIC HEALTH

Addis Ababa, Ethiopia

October 2021
PREVALENCE OF UNDER NUTRITION AND ASSOCIATED FACTORS AMONG
ADOLESCENT GIRLS IN SELECTED SCHOOL IN KOLFE KERANIYO SUB CITY ADDIS
ABABA, ETHIOPIA.

BY: SIMRET GIDEY (BSC.)

ADVISOR: ESKINDER WOLKA (PHD)

PROPOSAL SUBMITTED TO THE SCHOOL OF GRADUATE STUDENT OF UNITY

UNIVERSITY IN PARTIAL FULFILLMENT OF THE REQUAREMENTS FOR THE
DEGREE OF MASTERS OF PUBLIC HEALTH

Addis Ababa, Ethiopia

October 2021
Acknowledgment
First thanks to God, then I would like to offer my special thanks to my advisor ESKINDER
WOLKA (PHD) for his patient guidance, enthusiastic encouragement, inspiring and unreserved
support in the development of the proposal. I own and great gratitude to the Unity University
Medical College Department of Public Health for giving this chance.

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Table of Contents
Acknowledgment.........................................................................................................................................II
List of Abbreviation.....................................................................................................................................V
List of Figure...............................................................................................................................................VI
List of tables..............................................................................................................................................VII
Summary..................................................................................................................................................VIII
1 Introduction............................................................................................................................................1
1.1 Background........................................................................................................................................1
1.2 Statement of the problem...................................................................................................................2
1.3 Significance of the study........................................................................................................................3
2 literature Review....................................................................................................................................4
2.1 Magnitude of the problem..............................................................................................................4
2.2 Associated Factor.................................................................................................................................4
2.3 Couse of malnutrition..........................................................................................................................5
2.3 Conceptual Framework.........................................................................................................................6
3 Objective of the study..............................................................................................................................7
3.1 General objective...............................................................................................................................7
3.2 Specific objective...............................................................................................................................7
4 Method...................................................................................................................................................8
4.1 Study Area...................................................................................................................................8
4.2 Study Design...............................................................................................................................8
4.3 Source population........................................................................................................................8
4.3.1 Study population..................................................................................................................9
4.4 Eligibility Criteria........................................................................................................................9
4.4.1 Inclusion Criteria.................................................................................................................9
4.4.2 Exclusion Criteria................................................................................................................9
4.5 Sample size and sampling procedure...........................................................................................9
4.5.1 Sample size determination.................................................................................................................9
4.5.2 Sampling procedure...............................................................................................................10
4.5.3Data collection procedure..............................................................................................................10
4.5.4. Height Measurement....................................................................................................................10
4.5.5 weight Measurement..............................................................................................................10

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 4.6 Study variable..................................................................................................................................10
4.6.1 Dependent variable.....................................................................................................................10
4.6.2 Independent variable...................................................................................................................10
4.7 Operational Definition.....................................................................................................................11
4.8 Data Collection Tool and procedure..........................................................................................11
4.8.1Data collection tool........................................................................................................................11
4.8.2 Data collection procedure............................................................................................................11
4.8.3 Data processing and analysis........................................................................................................11
4.9 Dissemination of Finding.................................................................................................................12
5 Work Plan...........................................................................................................................................13
6 Budget................................................................................................................................................16
Personal allowances...........................................................................................................................16
Stationary materials...........................................................................................................................16
7 Reference...............................................................................................................................................18

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List of Abbreviation
BMI Body Mass

HAZ HEIGHT-FOR-AGE

SD Standard deviation

WHO World Health Organization

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List of Figure
Figure 1 Conceptual framework of nutritional status

Figure 2 Map of kolfe keraniyo

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 List of tables
Table 1 Gantt chart showing activities with time

Table 2 cost estimation of the research project

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Summary
Introduction: A body of evidences showed that adolescent undernutrition is a serious public
health problem in developing countries including Ethiopia. Adolescence period is the last chance
for curbing the consequences of undernutrition and breaking the intergenerational cycle of
malnutrition and poor health.

Objective: To assess prevalence of under nutrition and associated factors among adolescent girls
in kolfe keraniyo sub city selected school Addis Ababa Ethiopia, 2021.

Method: A school-based quantitative cross-sectional study design will be conducted among 397
adolescent girls from December 2021to January 2022. Simple random sampling technique will
used to select study participants. A structured interviewer-administered questionnaire and
anthropometric measurements will used to collect the data. The collected data will enter in to Epi
Data and exported to SPSS for further statistical analysis. Body Mass Index for age (thinness)
and height for age (stunting) will u sed to assess undernutrition of adolescent girls.

Work plan and budget: This study will be conducted from June-December 2021 and the total
cost of this study is estimated to 26,000 Ethiopian Birr.

Keywords: Underweight, Stunting, Adolescent girls.

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 1 Introduction
1.1 Background
Malnutrition is a major public health problem in both developed and developing nations.
Adolescents residing in developing nations, suffer more from undernutrition (1).

Both UN and WHO define adolescence as a segment of the population group age from 10 to 19  
years old it is a transition from childhood to adulthood period that has intense physical,
psychosocial and cognitive development. During this period, the final growth spurt occurs;
particularly, early adolescence after the first year of life is the critical period of rapid physical
growth and changes in body composition, physiology and endocrine. Up to 45% of skeletal
growth takes place, and 15–25% of adult height is achieved during adolescence. During the
growth spurt of adolescence, up to 37% of total bone mass may be accumulated. Regarding body
composition change, girls begin to store fat around the breast, hips and upper arm, but boys start
losing fat and develop muscle ( 2). Adolescence is a time of changing lifestyles and food habits,
changes that affect both nutrient needs and intake (3).

Worldwide, there are about 1.2 billion adolescents, representing more than 18% of the global
population. Nearly 90% of them live in developing countries, and approximately 600 million are
female( 4). In Ethiopia, 20–26% of the population are adolescents (5).

 Adolescents are in a vulnerable group for malnutrition and its consequences, because it is a
dynamic period of physical growth and mental development. Undernutrition starts before birth,
goes into adolescence and adult life, and can span into generations and results in short stature,
lean body mass, and is associated with deficiencies in muscular strength. In addition, it can
reduce resistance to infection and other debilitating conditions that reduce productivity ( 6,7 ,8).

Malnutrition in all its forms, particularly undernutrition including underweight for age, too short
for age (stunted), too thin relative to height (wasted), and functionally deficient in vitamins and
minerals, is a global issue, but in the developing countries, it is catastrophic (9, 10).

The impact of undernutrition also leads to stillbirths, small-for-gestational-age neonates,

complicated delivery, and even maternal death among married late-adolescent girls ( 11).

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 1.2 Statement of the problem.
When a young child isn’t properly nourished, her brain and her body can be severely damaged
because they don’t have nutrients they need to grow. This can cause a negative ripple effect for
the rest of her life, making it hard for her to do well in school, stay active and healthy, get a job
and so much more. An adequate well-balanced diet is the bedrock of child survival, health and
development. Well-nourished children are ready to learn. Undernutrition, by the same logic, is
devastating. It blunts the intellect, saps productivity, and perpetuates poverty.

Ethiopia has seen a steady redaction in stunting from58% in 2000 to 38% in 2016, in the
percentage of underweight children from 41% to 24% during the same period, and in wasting
from 12% to 10%. These trends indicate an improvement in chronic malnutrition over the past 15
years. Yet 28% child deaths in Ethiopia are associated with under-nutrition. In addition, a high
prevalence of various form of malnutrition among vulnerable groups has serious implication for
social development and economic growth.

Malnutrition further has lifelong implications in the form of increased infection and reduced
academic performance, and even affects future generations by increasing the chances of birth of
an underweight baby if the mother is malnourished. Hence improving adolescents’ nutrition is an
investment for the future. This age also forms an opportunity to correct dietary habits and set
right the nutritional deficiencies and hence prevent nutrition related chronic diseases later in life.
For all this to happen the first step would be to know the prevalence of and factors contributing
to malnutrition.

Thus, this study will be done to assess the prevalence of under nutrition and associated factors
among adolescent girls in selected school kolfe keraniyo sub city Addis Ababa, Ethiopia.

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1.3 Significance of the study
Malnutrition is widely spread problem affecting people who are found in all over the world,
including both the developed and developing countries. But the problem is mostly prevalent in
developing countries like Ethiopia, even though many governmental and nongovernmental
organizations are striving to decrease the prevalence. Problem of malnutrition is currently
existing problem. Prioritizing one extreme of malnutrition over the other is difficult on limited
budget. Nevertheless, under nutrition continues to be the main focus of research health care
spending. Adolescent nutrition receives very little attention and difficult to quantify accurately in
this age group due to rapid change in growth and development and lack of consensus over which
definition to use. Problem of malnutrition needs collaborative effort planners, policy makers and
the community at large. Therefore, this study will contribute baseline data on the issue and will
elicit support and promote cooperation among the different stakeholders towards the initiation of
a sustainable nutrition and health promotion program for adolescent girls in Addis Ababa.

3|Page
2 literature Review
2.1 Magnitude of the problem

A body of evidence showed that globally, adolescent undernutrition is a serious public health
problem in both developed and developing countries, but is disproportionally keeping sever in
developing countries, especially in Asia (32–65%) and Africa (4–30%), making them more
vulnerable to low productivity, poor health, and early deaths. In Sub-Saharan Africa, the
prevalence of adolescent undernutrition is 15–58%, which is higher from other African countries
( 12 ,13, 14, 15).

2.2 Associated Factor

2.2.1 socio-economic and demographic factor
There are a host of factors that influence the nutritional needs and nutritional intake of children.
Factors can be categorized as being both biological and non-biological. Biological factors
include age, gender, growth, disease states and genetic makeup. From non-biological factors are
socio-economic status is important. Socio -economic factor include occupation, education,
income, wealth and where someone lives.

Study conducted in India they found 36.2% of adolescent girls were malnourished, among whom
33.7% were obese and 66.3% were undernourished. Age and education of the mother and father
were found to be significantly associated with malnutrition (16).

There are few studies done in Ethiopia regarding the level of adolescent undernutrition in the
country. The Ethiopian nutrition baseline report revealed that the prevalence of stunting and
thinness in adolescent girls was 23 and 14%, respectively( 17). Other community-based studies
done in different parts of Ethiopia such as Somali, Oromia, and Tigray indicated that the
prevalence of both stunting and thinness were high in some rural parts of the country which were
22.9% stunted and 11.5% thin (18), 27.5% thin and 15.6% stunted( 19), and 21.4% thin and 26.5%
stunted (20), respectively.

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A study done in damot sore , southern Ethiopia, has attempted to determine the prevalence and
factors associated with stunting and thinness among rural adolescent girls. The results of the
study indicated that the prevalence of stunting and thinness was 29.6% and 19.5%, respectively.

The study was found revealed that older adolescent girls, mothers' education, mothers'
occupation, and wealth index was statistically significantly associated with stunting while
fathers' education, mothers' education, and frequency of meal per day were found to be
significantly associated with thinness (21).

2.3 Couse of malnutrition

Evidence showed that the causes of malnutrition are diverse and complex, but they are
categorized into two dimensions: immediate causes like inadequate diet and diseases; underlying
causes such as food insecurity, limited knowledge, local taboos, culture, inadequate health care
access, and poor hygiene-sanitation practices (22) .Scholars also reported that age groups, being
rural residence, having family size ≥5, parents’ educational status, dietary diversity score,
absence of latrine in household, unprotected water source for drinking, and food-insecure
households were determinant factors of under-nutrition among late-adolescent girls( 23, 24, 25, 26).

The nutritional status of children in this study was showed that under-nutrition was prevalent as
compared to the WHO/2007 international reference standards ( 27 ). In this study, multiple factors
are associated with under-nutrition which was similarly explained by a study done in Brazil ( 28).
This study found that children live in food insecure households are more likely to be stunted,
underweight and wasted (29 ). severe household food insecurity was significantly associated with
underweight in Ethiopia. (30).

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 2.3 Conceptual Framework
Socio -demographic
factor
Socio -economic factor
Age
occupation,
Sex
education status,
income,
living condition lives

Nutritional status

Clinical history

Immunization history Environmental factor

Diarrheal disease Safe water

Respiratory infection Personal hygiene

6|Page
3 Objective of the study
3.1 General objective
To assess the prevalence of under nutrition and associated factors among adolescent girls in
selected school in Kolfe keraniyo sub city Addis Ababa, Ethiopia.
3.2 Specific objective
To determine the prevalence of under nutrition among adolescent girls in selected school in
Kolfe keraniyo sub city.
To identify associated factors of under nutrition among adolescent girls in selected school in
Kolfe keraniyo sub city Addis Ababa, Ethiopia.

7|Page
 4 Method
4.1 Study Area
The study will conducted in Kolfe keraniyo sub city, Addis Ababa, Ethiopia. Kolfe keraniyo sub
city is the largest and the most populous sub city in Addis Ababa. According to a projection of
2007 population census (31), the population is estimated 537,561 in 2017. The sub city has 15
administrative areas (Woredas) with a total of 103,206 households.

Figure 1 map of kolfe keranio

4.2 Study Design

An institutional-based, cross-sectional study will be employed at selected school in kolfe keranio sub
city from JUNE -DECEMEBER 2021.

4.3 Source population

 All students, in selected school at the age of 10-19.

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4.3.1 Study population
All adolescent students (10–19) in selected school.

4.4 Eligibility Criteria

4.4.1 Inclusion Criteria
 Age 10-19
 Presence at school on the day of the study

4.4.2 Exclusion Criteria

 Students who will seriously ill and unable to participate in the
measurement procedure.
 Student who will be above or under the age of the groups.

4.5 Sample size and sampling procedure

4.5.1 Sample size determination

The sample size will calculate using single population proportion formula with the assumptions
of the prevalence of thinness among school-going adolescents of Mekelle City, Northern
Ethiopia, being 37.8% at a 32
95% confidence level and 5% margin of error adding 10% as a
contingency for non-response rate. where n=sample size, Z=Z-score at 95%, CI=1.96, p=37.8%,
d=marginal error=0.05, n= (1.96)2 * 0.378(1–0.378) =3.8416 * 0.378*0.622=361, (0.05) 2 (0.05)2
. By adding 10% non-response rate,

n = (z/ἀ/2)2 P(1-P)

d2

Where: n = Sample size z = critical value 1.96

p =0.378 taken from study previously conducted

d = precision (marginal error) = 0.05 Thus, the sample size will:

n = (1.96)2 x 0.378(1-0.378) = 361

(0.05)2

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Considering a non-response rate of 10% the total sample size, the study sample will be 397.

4.5.2 Sampling procedure

This will be cross sectional study involved 397 students randomly selected, from selected school
in kolfe keraniyo sub -city. Participants will carefully chose using a single-probability sampling
technique.

We chose kolfe keraniyo because previously there is no research on this topic and the population
size is wide. Students and the School will be selected by random sampling method

4.5.3Data collection procedure

Anthropometry measurement of height and weight will be taken and we will be interviewing the
students.

4.5.4. Height Measurement

Height measurement will carry out while the student removed her shoes, stand erect, looking
straight in horizontal plane with feet together and keens straight. During the measurement the
heels, buttock, shoulder blades and the back of the head will adjust to touch against the wall and
the measurement will record to the nearest 0.5cm.

4.5.5 weight Measurement

Measurement on body weight will be conducted using standard beam balance that is used in the
medical setup recorded to the nearest 0.1kg. Student weight will be taken with subject light
clothed and taken off. Besides, over worn closes such as scarf asked to remove during body
weight measurement.

4.6 Study variable

4.6.1 Dependent variable
Nutritional status of adolescent girls

4.6.2 Independent variable

Sex, Age, Educational status, Occupation, Marital status and Residency

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4.7 Operational Definition
Adolescents are individuals in the age group of 10–19 years of age. It is categorized as early
(adolescents in the age group of 10–13 years of age), middle (adolescents in the age group of 14–
16 years of age), and late adolescents (adolescents in the age group of 17–19 years of age) 33.

Stunting is if the height-for-age Z score is found to be below −2 SD of the 2007 WHO growth

reference. Severe stunting is diagnosed if it is below −3 SD 34, 35.

Thinness is if the BMI-for-age Z score < −2 SD of the WHO growth reference 2007. Severe
thinness is diagnosed if it will below −3 SD.

Body mass index (BMI) is defined as weight in kilograms divided by height in meters squared = Weight
(kg)/Height (m2)—normal weight if 18.5 kg/m2 < BMI < 25 kg/m2, underweight if BMI < 18.5 kg/m 2, and
overweight if BMI > 25 kg/m2.

4.8 Data Collection Tool and procedure

4.8.1Data collection tool
 Weight scale
 Height

4.8.2 Data collection procedure

The study will utilize open and close ended written questionnaire included 24-hour recall or
dietary diversity status will be forwarded for selected students from source population
randomly anthropometric measurements will be taken by trained personnel through taking
measurements like height, weight and middle upper arm circumference. Data will be
collected by trained data collectors and the supervision will be carried out by the research
team members.

4.8.3 Data processing and analysis

Data will be entered into Epi-Data and then exported to SPSS version 25 for further analysis.
will used to calculate the Z-score of weight-for-age, height-for-age and weight -for height of the

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children. Variables which will significant at p-value < 0.2 in the bivariable analyses were
candidate for entering into the multivariable logistic regression model to identify the independent
predictors for Nutritional status.

4.9 Dissemination of Finding

Ethical Consideration An official letter will be written from the research committee from UNITY
UNIVERSITY to get permission and support letter. The purpose of the study will be explained
to the study participants and a written consent will be taken from participants to confirm whether
they are willing to participate. Confidentiality of responses will also be ensured throughout the
research process.

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 5 Work Plan
SN Activity Jun Jul July Aug Aug Sep - Sep Sep Oct Oct Nov Dec Dec Jan Jan
2021 1-15 20-30 10-20 25-30 1 10-12 13-30 1-5 7-30 1-30 1-10 20-30 1-15 20-25

1 Proposal
development

2 1stdraft
proposal to
adviser

3 2nd draft
proposal to
adviser

4 3rd draft
proposal to
adviser

5 4th draft
proposal to
adviser

13 | P a g e
6 Final
proposal
submission

7 Proposal
defense

8 Incorporation
of comments
and ethical
clearance

9 Pretest of
data
collection
tool

10 Data
collection

11 Data entry
cleaning &
analysis

12 1st draft
report to

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 adviser

13 2nd draft
report to
adviser

14 Final thesis
submission

15 Final defense

Table 1 Gantt chart showing activities with time

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6 Budget

No Description Unit Duration Unit Quantity Subtotal

Cost(birr) (birr)
Personal allowances
[Link] Data collectors
Healthcare 10 days 300.00 4 12000
workers
[Link] Secretary Secretary 5 days 200.00 1 1000
[Link] Supervisor Health 10 days 500.00 1 5000
professional
TOTAL 18,000
Training
[Link]
Training Healthcare 1 day 200 4 800
workers
Total 800
Transportation cost
[Link] Transport round trip Per person 10 days 20.00 4 800
Total 800
Equipment’s, materials
Height and weight 4 300 1200
scale rent
Muac 4 25 100
Weight scale rent 4 300 1200
Meter 4 100 400
Skin fold
Total 2900

Stationary materials
Paper Pack 300 1 300
Pen Pack 250 1 250

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 Note pad Pack 150 5 750
Pencil Pack 60 1 60
Sharpener Piece 20 4 80
Photo copy Per page 1 1000 1000
File holder Pack 100 4 400
Blank cd Pack 150 1 150
Internet cost 20 hour 20 30 600
SUM 3990
TOTAL SUM 25,600

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7 Reference

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Nutr. 2012;15(1):142–8

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Bogin B, et al. Human life course biology: a centennial perspective of scholarship on the human pattern of physical
growth and its place in human biocultural evolution. Am J Phys Anthropol; 2018.

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. Staff U. The state of the world’s children 2011-executive summary: adolescence an age of opportunity; 2011

4
WHO. World Health Organization. Monitoring, evaluation and review of national health strategies: a
country led platform for information and accountability; 2011. p. 1–34.
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Eu T, States M, Programme NN, Assembly WH, Nutrition WHA, Stunting I, et al. Ethiopia Nutr
Country Fiche; 2015. p. 2012–4.

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Weres ZG, Yebyo HG, Miruts KB, Gesesew HA, Woldehymanot TE. Assessment of adolescents' under nutrition
level among school students in Eastern Tigray, Ethiopia: a cross-sectional study. J Nutr Food Sci. 2015;5(5):1.
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Hanson MA, Bardsley A, De-Regil LM, Moore SE, Oken E, Poston L, et al. The International Federation of
Gynecology and Obstetrics (FIGO) recommendations on adolescent, preconception, and maternal nutrition:
“think Nutrition First.”. Int J Gynecol Obstet. 2015;131(October):S213–53.
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USAID, Multi-sectoral nutrition strategy global learning and evidence exchange, east and southern
Africa regional meeting. 2010. [Link]
[Link].

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effectiveness D. Addressing child undernutrition: evidence review. 2014;(March).

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World Health Organization (WHO). Essential nutrition actions; improving maternal, newborn, infant and young
child health and nutrition. 2013.

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Central Statistical Agency (CSA) [Ethiopia] and ICF. Ethiopia Demographic and Health Survey 2016. Addis Ababa, Ethiopia,
and Rockville, Maryland, USA: CSA and ICF; 2016.

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World Health Organization (WHO). Essential nutrition actions; improving maternal, newborn,
infant and young child health and nutrition. 2013.

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PMNCH. Knowledge summary: women’s & children’s health. Partnersh Matern Newborn CHhild Heal
Knowledge Summ. 2012;18:1–4.

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WHO. World Health Statistics [Internet]. Vol. 27, WHO World Health Organization; 2012. p. 171
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Sci JNF, State R. Journal of Nutrition & Food Sciences Prevalence and Associated Factors of Stunting Among
Schoolchildren, in Debre Markos Town and Gozamen Woreda , East Gojjam Zone , Amhara; 2014.

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Nutritional status in adolescent girls: Attempt to determine its prevalence and its association with sociodemographic
variables. Smitha Malenahalli Chandrashekarappa1 , Narayana Murthy Mysuru Ramakrishnaiah1 , Renuka Manjunath

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Health E. for the National Nutrition Program of; 2009.
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Awel AA, Lema TB, Hebo HJ. Nutritional status and associated factors among primary school
adolescents of pastoral and agro- pastoral communities, Mieso Wored, Somali Region. Ethiopia: a
comparative cross-sectional study. 2016;8(November):297–310.
KT R, M A. Nutritional status and its associated factors among school adolescent girls in Adama City,
Central Ethiopia. J Nutr Food Sci. 2016;6(3):4–11.

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KT R, M A. Nutritional status and its associated factors among school adolescent girls in Adama
City, Central Ethiopia. J Nutr Food Sci. 2016;6(3):4–11.

20
Gebregyorgis T, Tadesse T, Atenafu A. Prevalence of thinness and stunting and associated factors
among adolescent school girls in Adwa town, North Ethiopia. Int J Food Sci. 2016;2016.

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undernutrition and Associated Factors among Adolescent Girls in Damot Sore District, Southern
Ethiopia)
Degu Demissie Gagebo  1 , Amene Abebe Kerbo  2 , Thilagavathi Thangave
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International Federation of Red Cross and Red Crescent Societies. Nutrition guidelines, 2013.

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Berhe K, Kidanemariam A, Gebremariam G, Gebremariam A. Prevalence and associated factors of adolescent
undernutrition in Ethiopia: a systematic review and meta-analysis. BMC Nutrition. 2019;5(1):49.
[Link]
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Amare Tariku AKB, et al. Stunting and its determinants among adolescent girls: findings from the nutrition surveillance
project, Northwest Ethiopia. Ecol Food Nutr. 2019;58(5):481–94.

25
Tariku A, Gonete KA, Bikes GA, Alemu K, Belew AK, Wassie MM, et al. Household food insecurity predisposes
to undiversified diet in Northwest Ethiopia: finding from the baseline survey of nutrition project, 2016. BMC
Res Notes. 2019;12(1):54. [Link]
26
Roba KT, Abdo M, Wakayo T. Nutritional Status and Its Associated Factors among School Adolescent Girls in
Adama City, Central Ethiopia. J Nutr Food Sci. 2016;6:493. [Link]

27
. de Onis M, Onyango AW, Borghi E, Siyam A, Nishida C, Siekmann J. Development of a WHO
growth reference for school-aged children and adolescents. Bull World Health Organ. 2007;85:660–7.

28
. Jardim Botelho A, Brooker S, Geiger SM, Fleming F, Lopes ACS, Diemert DJ, et al. Age Patterns in
under nutrition and helminth infection in a rural area of Brazil: associations with ascaris and
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. Belachew T, Hadley C, Lindstrom D, Gebremariam A, Lachat C, Kolsteren P. Food insecurity,
school absenteeism and educational attainment of adolescents in Jimma Zone Southwest Ethiopia: a
longitudinal study. J Nutr. 2011;10:29.
30
. Ali D, Saha KK, Nguyen PH, Diressie MT, Ruel MT, Menon P, et al. Household food insecurity is
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31

8 Annex
Appendix1: Information Shee

Good morning/good afternoon! My name is _____________________. I am here today to collect data

for a study to be conducted by Simret Gidey from Unity University, post graduate program. The
objective of this study is To assess the prevalence of under nutrition and associated factors among
adolescent girls in selected school in Kolfe keraniyo sub city Addis Ababa, Ethiopia . You are asked to take part
in this study and to respond genuinely and your cooperation is greatly helpful. Your participation is
voluntary and your name will not be written in this form and will never be used in connection with any
information you tell us. There is no risk in participating in this research project and there may not be
direct benefit to you but your participation may have direct or indirect contribution to the students. If
you have questions regarding this study or would like to be informed of the results after its completion,
please feel free to contact the principal investigator by using the following address.
Cell phone: +251 913566279

1 Appendix 2: Consent Form

My name is Simret Gidey, from Unity University, post graduate program. The objective of this study
is to assess the prevalence of under nutrition and associated factors among adolescent girls in selected school
in Kolfe keraniyo sub city Addis Ababa, Ethiopia. The information gathered in this interview will be used
only for academic purposes and are strictly confidential. Your full name will not be written down
anywhere and there will be no way to identify you. Your participation is voluntary. You may refuse to
answer any question and choose to stop the discussion at any time You can also ask questions about
this study at any time. There is no direct benefit or money to be given for you in participating to this
study. However, I hope that the study will benefit your community by helping me understand to asses
nutritional status of school children under the feeding program and its associated factors in primary
school and recommending what should will be done to improve their nutritional status.
In signing this document, I am giving my consent to participate in the study.

Mobile number: +251 913566279,

E-mail: simretgidey16@[Link].

I here approve my consent to take part in the study with my signature.

Signature ____________________

Date ______________________

Email: simretgidey16@[Link]

2 Appendix 3: Questionnaire

Interview for student’s parents/Guardians

ID ----------------------------------

Date of Interview -------------------------------------------

Starting Time ------------------------------------------------

Ending Time ---------------------------------------------------

Socio – Demographic Characteristics of the students:

S. No Question Response

1 Age

2 Sex

3 Grade

4 Weight

5 Height

6 MAUC

7 Do you have siblings? How many 1. Yes

2. No

8 If yes how many 1. Sister

2. Brother

9 Your position

10 What type of transport you used? 1. Taxi

2. Bus

3. On foot

11 Time taken to rich school 1. 15 minutes

2. >15 minutes

12 When did you start the feeding 1. 2011 E.C

program
2. 2012 E.C

3. 2013 E.C

4. 2014 E.C

13 What type of food you eat at

morning

14 What type of food you eat at

Socio demographic of caregiver
S. No Question Response

16 Care giver 1. Mother

2. Father

3. Other

17 Age

1. College and above

2. High school

3. Elementary
18 Education of the care
4. Read and write only
giver
5. Illiterate

19 1. house wife

2. employed

Occupation 3. business

4. daily laborers

5. others

20 Monthly income 1. 500-2000birr

2. 2001-4500birr

3. 4501-7000birr

4. 7001-9500birr

5. .> 95001birr
Socioeconomic status

21 Do you have Television 1. Yes

2. No

22 Radio 1. Yes
2. No

23 Refrigerator 1. Yes
2. No

23 What type of fuel does 1. Charcoal

your house hold mainly 2. Kerosene
used for cooking 3. Electric
4. Wood

24 Do You have a separate 1. Yes

room used as kitchen? 2. No
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